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PREJOB SAFETY INSTRUCTION LIST (LABOR PROTECTION, FIRE AND INDUSTRIAL SAFETY)
:
Foreman: T :
:
/ Day Start of
Trkulja Goran Shift: / Night works: 20-07 08.00
(, ... / Position, Surname ,Nam) ( / Sign) ( / Date) ( / Time)

: /, , , , ,
Subject for current date: MK
3300-C3ACOMMO-L12-00003-00-D REV03R,3300-3ACOMMON-L12-00015-00-D_03,3300-C3ACOMMON-L12-00017-00-D_02,3300-E51WCOMMO-L12-00014-00-D_REV02
( / Description of works and working conditions)

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Description of job location: TRAIN 1/114 SST 014, 111 PAU 002,146 SPP 001,002, JETTA (PRIAL)

(, , , , / Site, area, unit, facility, building)

/ Actual workplace hazards:


1,8 / , //
Workplaceatheightmore 1,8m , / 5 750 / 1,1 / Height of protection
Workareaaboveequipment, structures, Elevation/descending at / from height of more rail is less than 1,1m or absent
materials than 5m by stairs inclined 750 and more
( / / Swinging
) / Fall factor LackofHeight Factor back after falling (pendulum factor) 2 /
(characterization of height of possible falling) Workplace is situated closer than 2 m from
unfenced areas with height difference
, , , ,
/ / / Constrainedaccessto workplace / Items, work pieces, tools,
Openableorclosedhatches, Insecurityofanchorage, which mayfall from above
manholesinworkarea attachmentpointofsafetyharness
, , , / , /
Movingitems, materials / Uneven, slipperyworksurface Moving machinery, mechanisms Deteriorated, fragile structures
/ High light ,
/ Highvoltageinthecircuit intensity / Excesspressure in the vessels and Dangerous, harmfulchemicals
equipment
/ t 0 / t 0 / /
/ Veryhigh / verylowambientt0 , / Increasednoise level Increased vibration level
Very high / very low t0of surface of equipment,
materials
, ,
/ Worksorequipment, , / Flying particles , , / Highvoltageinthecircuit
producingignition ofdisintegrated materials, equipment / Flying sparks, molten metal
splashes, particles, fragments
- / ,
/ / High / High concentration of harmful / Insufficient contentof / High dust content, gas
concentration of explosive and fire hazardous vapors /gases oxygen in work environment contamination
vapors /gases
/ , , ,
/ Insufficient illumination of work area Severe weatherconditions / Sharpedges, , / Uneven,
burrsofworkpieces, toolsandequipment slipperysurfaceofwalkwaysandworkingarea

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(), / Deterioratedearth (soils), / Workinginaconfinedspace / Open wells/boreholes, /
stones excavations/earthworks Intakeofdangerousand/or harmful products
from adjacent production areas
() / Others (toberecorded, if any):
, / Equipmentandtools:
/ / , , / / Drill rig / Gas
Constructions for lifting Excavating machine Man lift, lifting tower, basket cylinders
, / Stairs, , / Scaffold, / Rigid /
ladders trestle / Temporarybarricade attachment line Flexibleattachment line
/ / /
Grinding machine Hand-heldpower / Handimpacttools / / Primary
Gascutting/Weldingequipment fire-fighting tools
/ , () / Others (to be recorded, if any):
/ LOTOequipment / Lightingequipment for work
place, alarmsand communication
, / JobSafetySystems, PPE:
/ Special cloth / Protective hardhat / / / Protective
Protectivefootwear(boots or shoes) goggles / Shield
/ Protective gloves / / Respirator / / Ear protection (muffles) / / /
gas mask Weldergoggles / mask / shield
/ Safety harness / /
/ ShockAbsorberLanyard Safetylanyardtractiondevice
Weldershieldwithenforcedairsupply
/ , / Forked Lanyard
Protectionforcrawling , / Steelrope, fire- Evacuationandrescuesystem
proofedsling, chain
()
/ Specific conditions for current date:

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Recordofattendees.Labor protection, fire and industrial safety in working process
: , , ,

IMPORTANT:By undersigning this document, I confirm that I have received complete information about job, hazards and I clearly understand job tasks
/ /
/ NAME / Craft
Instructor Attendee
1.


6
Trkulja Goran

2.
.
6 Trkulja Goran

3.

6 Trkulja Goran

4.

6 Trkulja Goran

5.

6 Trkulja Goran

6.
6 Trkulja Goran

7.
6 Trkulja Goran

8.

6 Trkulja Goran
9.

6 Trkulja Goran

10.

Trkulja Goran
11.
Trkulja Goran
12.
Trkulja Goran
13.
Trkulja Goran

14.

Trkulja Goran

15.
Trkulja Goran

16.
Trkulja Goran
17.
M Trk,,,ulja Goran
18.
/ Trkulja Goran

19.

/ Trkulja Goran
20.
/ Trkulja Goran
/ CONTROL LIST
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Itshallbefilledduringinspectionofsafeoperation and compliance with safety requirements)

/ Yes | No
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1. Content of working team corresponds to the above mentioned record list

2. Workers are instructed and authorised

3. Workers are aware of possible hazards at the work place
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4. Proper safety systems and PPE are applied

5.
All measures for safe operation stated in the instruction list corresponds to actual situation at the work place


6. All rules for safe operation are observed
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HSEspecialist: 20-07
(, ... / Position, Surname ,Name) (/ Signatures) ( / Date)


Supervisor: Trkulja Goran 20-07
(, .. ./ Position, Surname ,Name) (/ Signatures) ( / Date)